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Master the Boards > Endocrinology > Flashcards

Endocrinology Flashcards

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1
Q

additional finding in kallman syndrome

A

RENAL AGENESIS in 50%

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2
Q

growth hormone deficiency in adults

A 
RARELY have symptoms,
subtle signs
- central obesity
- increased LDL and CH levels
- reduced lean mass
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3
Q

GH levels low

A

NOT that helpful since GH is pulsatile and maximum at night

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4
Q

confirming low GH

A

no response to arginine infusion

no response to GHRH

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5
Q

prolactin levels low confirmatory Dx

A

no response to TRH

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6
Q

metyrapovnse normally causes…

A

ACTH to rise, since inhibits 11 beta hydroxyls, thus decreasing output of the adrenal gland

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7
Q

before starting thyroxine what should you do,, for panhypopituitarism,,,,

A

CORTISONE before thyroxine

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8
Q

additional info for PC acromegly

A 
carpal tunnel
body odour
colonic polyps
arthralgias 
HTN
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9
Q

what can give a similar picture as acromegaly

A

GH abuse

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10
Q

best initial test for acromegaly

A

IGF-1

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11
Q

when should MRI be done in acromegaly

A

AFTER laboratory identification of acromegaly

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12
Q

what is co-secreted with GH

A

PRL

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13
Q

possible drugs for tx of acromegaly

A

cabergoline: DA agonist, inhibits GH release
octreotide or lanreotide: somatostatin inhibits GH release
PEGVISOMANY

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14
Q

PEGVISOMANT

A

GH receptor antagonist– inhibits IGF release from the liver

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15
Q

physiologic causes of hyperPRL

A
  • pregnancy
  • intense exercise
  • renal insufficiency
  • increased chest wall stimulation
  • cutting pituitary stalk– no dopamine– no inhibition of PRL
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16
Q

drug causes of hyperPRL

A
  • antipsychotic meds
  • methyldopa
  • metoclopramide
  • opiods
  • TCA’s
  • verapamil
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17
Q

ONLY CCB to cause hyperPRL

A

VERAPAMIL

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18
Q

first thing necessary to do if patient has hyperPRL

A

PREGNANCY TEST

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19
Q

work up for hyperPRL

A
  • TFTs
  • Bun/Cr (since kidney insuff elevates PRL)
  • LFTs (since cirrhosis elevates PRL)
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20
Q

which dopamine agonist is preferred for tx of hyperPRL

A

CABERGOLIN

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21
Q

when to tx hypothyroidism

A

High TSH (X2) + normal T4

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22
Q

when to decide on thyroid replacement in hypothyroidism

A

anti-TPO when TSH high, and T4 normal

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23
Q

involuted non palpable thyroid

A

exogenous thyroid hormone use

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24
Q

low TSH and decreased RAIU

A
  • subacute thyroiditis– painful
  • painless “silent” thyroiditis
  • exogenous thyroid hormone use
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25
tx of silent thyroiditis
NONE
26
tx of subacute thyroiditis
ASPIRIN
27
which thiourea drugs is preferred for hypthyeroidism
METHIMAZOLE
28
tx of graves opthalmopathy
STEROIDS
29
what must you do if FNA says follicular adenoma
REMOVE SURGICALLY-- since can't tell if benign or malignant from FNA alone
30
90% of hypercalcemia seen in
CANCER PATIENTS
31
tx of hypercalcemia of malignancy
saline bisphosphonates ------ if not working yet--> CALCITONIN
32
how to tx hypercalcemia from granulomatous disease/ sarcoidosis
PREDNISONE
33
how long does it take for bisphosphonates to work
SEVERAL DAYS
34
bone effects imaging for hyperPTH
DEXA is greater than bone xr
35
imaging of neck for hyperPTH
dont pre-op for planning surgery
36
3 new random causes of hypocalcemia
1. hypoMg: since need magnesium to cause release of PTH 2. renal failure 3. low albumin: causes decrease in 0.8 calcium
37
low albumin causing hypocalcemia
decrease total calcium | normal free calcium= ASYMPTOMATIC
38
EKG for hypocalcemia
PROLONGED QT
39
extra tid bits of info for cushings
- erectile dysfunction in men - cognitive disturbance--> psychosis - polyuria
40
best initial test for hypercortisolism
24-hr urine cortisol-- more specific
41
next best test for hypercortisolism
1mg overnight DXM
42
FP's with 1 mg overnight DXM suppression test
- depression - alcoholism - obesity
43
best initial test for determining the cause/location of hypercortisolism
ACTH level
44
ACTH level in cushing disease
increased
45
ACTH level in cushing syndrome
decreased
46
ACTH level increased, now what
MRI brain
47
negative MRI brain for cushings, now what
inferior petrosal sinus sampling for ACTH, possibly after stimulating with CRH
48
general endocrine rule
confirm the lab results first, THEN do imaging
49
cushing disease suppression test
YES suppresses
50
cushing syndrome/ cancer
NO doesn't suppress
51
labs in cushings
``` hyperglycemia hyperlipidemia HYPOKalaemia metabolic alkalosis LEUKOCYTOSIS ```
52
why is adrenal crisis from the pituitary less common?
because the pituitary makes ACTH, which has a very little role in regulating aldosterone
53
labs in hypoadrenalism
``` hypoglycemia hyponatremia HIGH BUN HYPERkalaemia metabolic acidosis EOSINOPHILIA ```
54
what type of white cell is elevated in hypoadrenalism
EOSINOPHILS
55
dx or tx of adrenal crisis more important
TX
56
which steroid should we give when patient with hypoadrenalism has postural instability
fludrocortisone-- has sufficient aldosterone-like effect
57
steroid in adrenal crisis
hydrocortisone-- LIFE SAVING
58
best initial test for phaeo
24hr urine metanephreines, VMA
59
after biochemical testing for phaeo
CT adrenals
60
location of phaeo outside the adrenals imaging,
MIBG scanning
61
dx of DM
2 FBG > 125 1 random glucose >200 + symptoms OGTT-- increased glucose HbA1c> 6.5%
62
goal HbA1c level in DM
less than 7%
63
which diabetes drugs cause weight loss
incretin mimetics
64
nateglinide, repaglinide
stimulators of insulin release, but don't contain sulfa
65
onset: rapid acting insulin
5-15 minutes
66
peak action: rapid acting insulin
1 hour
67
duration: rapid acting insulin
3-4 hours
68
onset: short acting insulin
30-60 minutes
69
peak action: short acting insulin
2 hours
70
duration: short acting insulin
6-8 hours
71
onset: intermediate acting insulin
2-4 hours
72
peak action: intermediate acting insulin
6-7 hours
73
duration: intermediate acting insulin
10-20 hours
74
onset: long acting insulin
1-2 hours
75
peak action: long acting insulin
1-2 hours
76
duration: long acting insulin
24hrs
77
DKA presentation
in BOTH DMT1 and DMT2
78
potassium replacement DKA
replace potassium when levels are approaching normal
79
what factor indicates severity of DKA
serum bicarb (if very low, risk of death)

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